GNUR 297 Midterm Exam Study Guide(RATED 100%) | VERIFIED BY TOP PROFESSORS

GNUR 297 Midterm Exam Study Guide
Module 1
Chapter 1: Nursing Research

 Nursing Research: validates / refines existing knowledge and generates new knowledge
o Directly / indirectly influences nursing practice - Key EBP
 Evidence based practice: based off studies that promote quality safe and cost effective outcomes
o Best research evidence: empirical knowledge gained from quality study findings
o Clinical expertise: knowledge and skill of the healthcare provider
 Purposes of Research for EBP:
o Description: identify SS, describe disease and all aspects of the patients life
o Explanation: why certain events occur. Link data to diagnosis (risk factors to causes of illness)
o Prediction: estimate a probable outcome (Predict risk, behavior)
o Control: control or manipulate the situation to produce the desired outcome
 Case Study: in depth analysis and systematic description of a patient or group
o Promotes understanding of health intervention - Practice related research
 Nursing Competencies: Patient centered care, team work, EBP, quality improvement, safety, informatics
o Quality / Safety Education for nurses: knowledge, skill and attitude statements for each competency
 Nursing Traditions: Practice needs to focus more on EBP rather than tradition
o Positive: developed from effective past experience
o Negative: limit knowledge (often not questioned because it has been done for years)
 Borrowing: taking knowledge from other disciplines (medical model)
o Best to integrate other disciplines knowledge into the holistic view of nursing
 Trial and Error: used when uncertain (knowledge unavailable) all patients are different
o Can be harmful and time consuming - Best to use EBP when possible
 Role Modeling: imitation - Mentor: intense role modeling
 Intuition: insight that usually cant be explained logically (gut feeling)
o Really is a result of deep knowledge (hard to communicate)
 Reasoning: organizing ideas to get to a conclusion
o Inductive: going from specific ideas to make a general statement
o Deductive: general to specific
 Premise: a proposed relationship between concepts. Must be true to deduct
 Quantitative Research: common in nursing (numerical)
o Descriptive: describes situations
o Correlational: examines relationships
o Quasi-experimental: determine effectiveness of nursing intervention
o Experimental: determine effectiveness of nursing intervention
 Qualitative: subjective approach (more holistic) behaviors which are hard to quantitate (emotion)
o Phenomenological: inductive descriptive approach (lived experience)
o Grounded Theory: inductive technique to refine a theory about a particular phenomenon
o Ethnographic: study culture
o Exploratory-descriptive: investigates a problem in need of a solution
o Historical: review past mistakes and accomplishments
 Outcome Research: result of care (patients response, finances, satisfaction)
 Strategies to Synthesize research evidence:
o Systemic review: comprehensive synthesis of research literature
 Used to determine the best evidence available to address a health question
o Meta analysis: combining results of 2 quant studies into single stat
 Highest level of evidence about an intervention
o Qualitative research synthesis: integrating findings from qualitative studies
o Meta-Synthesis: qualitative interpretation (rather than combination)
o Mixed method systematic review: variety of study designs (qual quant)
 Levels of Research Evidence: the strength of a study (it is a continuum) strengthened by repetition
o Quantitative experimental: is the strongest

,  Critical Appraisal of Research: judge strength limitation meaning and significance of a study
Chapter 4: Nursing Research
 Nazi Medical experiments: expose Jews to high altitudes, freezing temp, disease, poison drugs surgery
o Useless because of ethics and poorly executed experiments
o Nuremberg Code: scientist brought to trial (subject ethics code was developed)
 Declaration of Helsinki: stemmed from Nuremberg code. Protect life, health, dignity, privacy
o Only experiment when the benefits outweigh the risks
o Therapeutic: experiment may have beneficial result
o Nontherapeutic: may benefit future patients but probably not the initial subjects
o Recently they must provide placebo group w/ access to proven diagnostics/therapy (after study)
 Tuskegee Syphilis Study: study of syphilis in African American men (40yr long)
o Purpose: determine natural cause of syphilis (not informed about purpose/ procedure)
o Examined periodically but never treated (withheld treatment deprived)
 Willowbrook Study: institute for mentally retarded injected children with hep (Parents gave permission)
o Defense: kids would get it anyway, they also had better supervision/cleaner rooms/more nurses
 Jewish Chronic Disease Hospital Study: injected live cancer cells into unknowing subjects
o Purpose: see patients rejection response to live cancer cells
 Department of Health, Education, and Welfare: (DHEW) protection of human subjects 70’s
o Slowed approval of studies and decreased studies
 National Commission for the protection of Human Subjects of Biomedical and Behavioral Research:
o 1) Principle of respect for persons: right to self determination (to participate or not)
 Autonomy: those who are less autonomous are entitled to more protection (children)
o 2) Principle of Beneficence: do the most good
o 3) Principle of Justice: fair treatment (= risk and benefit)
 Health Insurance Portability and Accountability Act (HIPPA): patient privacy
o Has negatively affected research (trying to lessen its impact on research)
 Human rights:
o Self determination: freedom to conduct life the way they choose
 Violation:
 Coercion: threat or reward to obtain compliance
 Covert data collection: unaware of data collection
 Deception: misinforming a subject about the experiment
 Diminished autonomy: venerable subjects (children/ ill/ mental)
 Have a right to more protection (+ susceptible to coercion / deception)
 Researcher needs to justify working with them
o Research is therapeutic/ low risk/ using low and high autonomy subjects
 Neonates: (viable/ non viable) Risks must be asses, parents informed,
o If it’s the Only way to gather medical knowledge or is possibly therapeutic
 Children: cant give consent until 7 (all on parents) after 7 consent is necessary
o Assent to participate: child’s agreement to participate
o Permission to participate: parental agreement
 Pregnant women: more protection because of fetus (Should benefit mom or baby)
 Mental Illness: may be unable to give consent (ask legal representative)
 Terminally Ill: they have + risk and – benefits
o Illness may affect the results - Research may compromise care
 Confined ppl: (prisoners/hospitalized)
o Prisoners: - autonomy by law (coercion: fear harm desire money)
o Hospitalized: ill and confined May feel coerced (fear – in care) or obligated
o Right to Privacy: what info will be shared and withheld
 Private: attitude, beliefs, behavior, opinions, records
 HIPPA:
 Covered Entities: healthcare providers
 Individually Identifiable Health Info: stuff you cant share
o Protected health information (PHI)